Below are possible answers to challenging questions that your children may ask you about your cancer diagnosis:
Q: What is cancer?
You may tell younger children: “Cancer is a disease that happens when bad cells stop the good cells from doing their job. These bad cells can grow into a lump and can spread to other parts of the body.”
For older children and teenagers, you may say: “Cancer is the name for more than 200 diseases in which abnormal cells grow and rapidly divide. These cells usually develop into a lump called a tumour or they may spread through the blood. Cancer may spread to other parts of the body.”
Q: Are you going to die?
This is the question that most parents fear, but often it doesn’t mean what you think. For example, younger children may really mean “Who is going to look after me?” Older children may be wondering, “Can we still go away during the school holidays?”
Try to explore the question by asking, “Do you have something in particular you’re worried about?” or “What were you thinking about?” You can explain that the treatment you are receiving is the result of many years of research and that treatments are improving all the time. If your child knows someone who has died of cancer, let them know that there are many different types of cancer and everyone responds differently.
Children and teenagers often have many questions about death and dying. Cancer commonly prompts them to reflect on their own life and the lives of those they care about.
A: “We don’t expect that to happen, but I will probably be sick for a while. I am doing everything I can to be well. Sometimes it makes me sad, and I wonder if you get sad too.”
Learn more about end-of-life discussions.
Q: Was it my fault?
Some children may ask you directly if they caused the cancer, while others worry in silence, so it’s best to discuss the issue.
A: “It’s no-one’s fault I have cancer. Scientists don’t know exactly why some people get cancer, but they do know that it isn’t anything you did or said that made me sick.”
“You did not cause this cancer. There is nothing you could have said or done that would cause someone to have this illness.”
Q: Can I catch cancer?
A common misconception for many children (and some adults) is that cancer can spread from person to person (is contagious). This belief may be reinforced because when patients have chemotherapy they need to avoid contact with people who are sick. This is to protect the person with cancer from picking up infections, not to protect everyone else.
A: “You can’t catch cancer like you can catch a cold by being around someone who has it, so it’s okay to hug or kiss me even though I’m sick.”
“Cancer can spread through the body of a person with cancer, but it can’t spread to another person.”
Q: Who will look after me?
When family routines change, it’s important for children to know how it will affect their lives: who will look after them, who will pick them up from school, and how roles will change. Try to give them as much detail as possible about changes so they know what to expect. For older children, it’s helpful to ask them what arrangements they’d prefer.
A: “We will try to keep things as normal as possible, but sometimes I may have to ask Dad/Mum/Grandpa to help out.”
Q: Do I have to tell other people about it?
Your children may not know who to tell about the cancer or what to say. They may not want to say anything at all. It’s a good idea to ask how they feel about talking to others.
If you’re planning to inform teachers, the school counsellor or principal, talk to your kids first. Teenagers and even younger children may be reluctant for the school to know, so explain the benefits of telling the school and then chat about the best way to approach the discussion. Ask if your teenagers want to be involved in these discussions.
A: “You can tell your friends if you want to, but you don’t have to. People we know may talk about the diagnosis, so your friends might hear even if you don’t tell them. Many people find it helps to talk about the things that are on their mind.”
“Do you worry about how your friends will react or treat you?”
“I need to let your teachers know so they understand what’s happening at home at the moment. We can talk about who to tell and how much we should say.”
“Sometimes people talk about illness but they don’t know the full story. If the kids at school are talking about the cancer, let me know so we can discuss any things that they have got wrong.”
Q: Is there anything I can do to help?
Answering this question can be a delicate balance. Letting kids know that they can help may make them feel useful, but it’s important that they don’t feel overwhelmed with responsibility.
Some parents may feel hurt if their children don’t ask how they can help, but it’s common for children not to think to offer.
A: “Yes, there are lots of things you can do to help. We will work out what those things can be, and what will make things easier for everyone. Is there something in particular you would like to do?”
“Some help around the house would be good, but it’s important that you keep up with your schoolwork and you have some time for fun and for seeing your friends.”
→ READ MORE: What words should I use?
It is often helpful to talk to other parents who have or have had kids at a similar age to yours when diagnosed. Talking to another parent who has travelled the same road can be reassuring.
MIRA, MOTHER OF TWO CHILDREN AGED 3 AND 12
Podcast: Explaining Cancer to Kids
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Prof Jane Turner AM, International Psycho-Oncology Society President Emeritus,The University of Queensland, QLD; Taylor Baker, Consumer; Dr Ben Britton, Principal Clinical and Health Psychologist, Head of Psychology, Hunter New England Mental Health, NSW; Camp Quality; Dr Lisa Cuddeford, Head of Department, WA Paediatric Palliative Care Service, Perth Children’s Hospital, WA; A/Prof Peter Downie, Head, Paediatric Haematology–Oncology and Director, Children’s Cancer Centre, Monash Children’s Hospital, VIC; Dr Sarah Ellis, Clinical Psychologist, Kids Cancer Centre, Sydney Children’s Hospital, NSW; Malia Emberson-Lafoa’i, Consumer; Kate Fernandez, 13 11 20 Consultant, Cancer Council SA; Jane Gillard, Consumer; Mary McGowan OAM, International Childhood Cancer Advocate, VIC; Annette Polizois, Senior Social Worker, Women, Family and Emergency Care Team, Royal North Shore Hospital, NSW; Rhondda Rytmeister, Clinical Psychologist, HeadWayHealth (formerly Snr Clinical Psychologist, The Cancer Centre for Children, Westmead, NSW); Nadine Street, Head of Social Work and Social Welfare, HNE Mental Health Service, NSW; Warren Summers, Online Counsellor, Canteen, NSW.
We would also like to thank the health professionals, consumers, organisations and editorial teams who have worked on previous editions of this title, and we are grateful to the parents and young people whose real-life stories have added to the richness and relevance of this book.
We thank and acknowledge Dr Paula K. Rauch, MD, Founder and Director, Marjorie E. Korff PACT (Parenting At a Challenging Time) Program and Associate Professor of Psychiatry, Harvard Medical School, whose research and writing on helping parents talk to their children about cancer was used as source material for this book and has been adapted in several sections: pages 8–11, How children understand cancer; page 22, Answering key questions: Are you going to die?; page 26, Involving the school or preschool; pages 30–31, Hospital visits; and pages 36–37, Encouraging family time. We also thank the American Cancer Society for permission to use and adapt material on pages 8-11 from its book Cancer in Our Family: Helping children cope with a parent’s illness (2013); Macmillan Cancer Support for permission to use its book Talking to Children and Teenagers When an Adult Has Cancer (2013) as a source of information; Jessica Watt, Oncology Social Worker, The Children’s Hospital at Westmead, for her contribution on page 20, When another child has cancer; and Diane McGeachy, Hobart Counselling Centre, for contributing material for page 37, Spending one-on-one time.
View the Cancer Council NSW editorial policy.
